Mothers from a Hilly region speak: Factors influencing maternal health in north India

Abstract

Background: Maternal health is an indicator of the development status of a country. Reducing the maternal mortality ratio needs better maternal health services delivery and management of the factors at the community level. Aims: To explore the factors that contribute to maternal health in Hamirpur district of Himachal Pradesh in North India Materials and methods: A qualitative study using focus group discussion was conducted among women. Interviews were semi-structured, thematic and included open-ended questions. Interview topics included support and care of the family, the importance of male child, problems faced in the hospital during an antenatal checkup, knowledge of danger signs during pregnancy and preference of place of delivery. Results: One core category emerged, ‘factors that affect maternal mortality, which connected the categories ‘community-level factors” and ‘hospital-level factors’. Barriers to access antenatal care services are: “inadequate family support” and “inadequate knowledge of danger signs in pregnancy”. “Negative attitude of healthcare staff” and “fixed day ANC care” are the factors which pose as a barrier from delivering baby in the hospital and seeking care. Conclusion: The study concluded that there are community-level issues and health system level issues which predict maternal health. The need of the hour is to launch community-based programs to educate people about the importance of family support in ANC care. There is a need to dispel the notion regarding preference for a male child. Government initiatives like Beti Bachao Beti Padhao should be promoted urging people to change their patriarchal attitudes toward girls. Good behavior from hospital staff and avoiding fixed day ANC care will go a long way in promoting institutional delivery.